Distinguished Lecturer Nomination Form

Distinguished Lecturer Nomination Form

Sponsoring Technical Committee*

Select

First Name*

Last Name*

Affiliation*

Affiliation Type

Academia

Government

Industry

Email Address*

Phone Number (w/ Country Code)*

Webpage URL*

Short Biography*

Limit to 200 words

Region 1 (Americas)

Region 2 (Europe, Middle East & Africa)

Region 3 (Asia & Pacific)

Gender*

Title of Talk #1*

Abstract of Talk #1*

Limit to 200 words

Title of Talk #2

Abstract of Talk #2

Limit to 200 words

Attachments*

Include: -Photo -CV

Drag and drop files here or

Nominator's Name*

Nominator's Email Address*

Nomination Date*

Send me a copy of my responses